Quality and safety leveraging best practice coaching methods Coordinated care among team members Access to care using diverse methods Personalized care with the patient at the center Rights Reserved by ViiNetwork Inc Confidential and Proprietary to ViiNetwork Inc ViiMed com For more information on how our Peri Operative workflow benefits you visit ViiMed com American Academy of Orthopaedic Surgeons AAOS A Patient and Family Centered Collaborative Care PFCCC is safe effective and timely care achieved through cooperation among the orthopaedic surgeon an informed and respected patient and family and a coordinated health care team Aligns with PFCCC EXTEND

Introduction About This workbook contains the E X T E N D orthopaedic clinical pathway with detailed information on patient interactions and observations throughout the path to recovery Please review each section and select your options to configure your new workflow Pathway Key The workflow steps timeline circles in green are the required steps in the pathway and are considered best practice The steps highlighted in yellow are optional patient activities The steps in dark blue are configurable patient interactions Keep in Mind All of the patient steps in the pathways and their interactions are documented in the E X T E N D Coordination console or in the EMR Rights Reserved by ViiNetwork Inc Confidential and Proprietary to ViiNetwork Inc 1

Pre Op Welcome Message What Welcome Aboard is the first activity that the patient will complete in the program The activity consists of a video from their care team and an overview of their care plan When The activity is sent to the patient immediately after he or she is enrolled Why The message the doctor delivers here is to welcome the patient to the program outline what the patient should expect and ensure the patient is in the best care possible Add a Partner in Care What This activity allows the patient to choose whether or not he or she wants to include a loved one in the recovery process The patient receives a video explanation of what a partner in care is before choosing whether to enroll someone When The activity is sent to the patient upon completion of the welcome message Why Not all patients need someone to help them but it can be a valuable tool to have additional assistance The partner in care is there to help keep the patient on track and can inquire the care team if necessary Standard Optional Configurable Rights Reserved by ViiNetwork Inc Confidential and Proprietary to ViiNetwork Inc 3

Pre Op Pre Op Education What The activity contains an educational video regarding the patient s upcoming surgery When The patient receives the activity 3 weeks prior to the surgery date Why The educational materials answer many questions the patient may have prior to his or her surgery This relieves the care team of taking time out of their day to answer phone calls and emails containing common patient questions Additionally the care team saves time in pre operative education each week Pre Op Checklist What The activity contains typical checklists for the patient prior to surgery e g what to bring to the hospital etc It also contains a downloadable copy of the checklist When The patient recieves the checklist 2 weeks 1 day prior to the surgery date Why The checklist ensures the patient is prepared which allows the surgery to remain on schedule and results in fewer surgery cancellations Standard Pre Op Checklist OR Add Custom Checklist see Appendix Standard Optional Configurable Rights Reserved by ViiNetwork Inc Confidential and Proprietary to ViiNetwork Inc 5

Patient Reported Outcomes to EMR Interoperability What E X T E N D posts the results of the patient outcomes to the EMR which consist of the following Range of Motion The degree of motion that is measured by the care team during the knee flexion and hip abduction are recorded into the EMR Patient Reported Outcomes Surveys The patient takes this survey 6 times throughout the virtual care process pre surgery post op 30 60 90 180 365 days The date and survey responses are recorded and posted back to the EMR Patient Satisfaction Survey The patient takes the patient satisfaction survey 2 weeks after his or her surgery Risk Complication Survey The patient takes this survey 5 times throughout the virtual care process post op 3 7 30 60 90 days When Outcomes are sent directly to the EMR once the proper individual provides the data Why Patient outcomes can be used to show patient quality care They can also be used for reimbursement Standard Optional Configurable Rights Reserved by ViiNetwork Inc Confidential and Proprietary to ViiNetwork Inc 11

PROMIS Appendix 1 In general how would you rate your overall health Excellent Very good Good Fair Poor 2 In general how would you rate your overall quality of life Excellent Very good Good Fair Poor 3 In general how would you rate your overall physical health Excellent Very good Good Fair Poor 4 How would you rate your mental health which includes your mood and your ability to think Excellent Very good Good Fair Poor 5 In general how do you rate your satisfaction with your social activities and relationships Excellent Very good Good Fair Poor Rights Reserved by ViiNetwork Inc Confidential and Proprietary to ViiNetwork Inc 14

Appendix 6 In general rate how well you follow through with your usual social activities and roles Including activities at home work in your community responsibilities as a parent spouse etc Excellent Very good Good Fair Poor 7 Rate how well you can carry out your everyday physical activities such as walking climbing stairs carrying groceries or moving a chair Excellent Very good Good Fair Poor In the past 7 days How often have you been troubled by emotional problems such as feeling anxious depressed or irritable Never Rarely Sometimes Often Always In general how would you rate your fatigue levels None Mild Moderate Severe Very Severe How would you rate your pain on average 1 10 Rights Reserved by ViiNetwork Inc Confidential and Proprietary to ViiNetwork Inc 15

Risk Complication Surveys Appendix Are you having any trouble breathing or chest pain now Yes No Do you have a cough and or fever A fever is a temperature greater than 99 0 Yes No Do you have any active bleeding on your incision Yes No Do you have any clicking in the joint during exercises Yes No Are you having increased redness swelling or pain in your repaired joint Yes No When did you last take pain medication Haven t taken any meds 1 6 hours ago 7 hours ago Rights Reserved by ViiNetwork Inc Confidential and Proprietary to ViiNetwork Inc 16

Patient Satisfaction Surveys Appendix Questions are answered on a 1 10 scale with 10 as the best possible score and 1 as the worst possible score 1 During your hospital stay how would you rate your communication with your nurses 2 During your hospital stay how would you rate your communication with your doctors 3 During your hospital stay how would you rate the responsiveness of the hospital staff 4 During your hospital stay how would you rate how the care team handled your pain management 5 During your hospital stay how would you rate your care team in effectively communicating everything you needed to know about your medications 6 During your hospital stay how would you rate the clarity of your discharge information 7 During your hospital stay how would you rate your care transition experience 8 During your hospital stay how would you rate the cleanliness of the hospital environment 9 During your hospital stay how would you rate the quietness of the hospital environment 10 Using any number from 0 to 10 where 0 is the worst hospital possible and 10 is the best hospital possible what number would you use to rate this hospital during your stay 11 Using any number from 0 to 10 where 0 represents Definitely no and 10 represents Definitely yes how would you rate your likeliness in recommending this hospital to your friends and family Rights Reserved by ViiNetwork Inc Confidential and Proprietary to ViiNetwork Inc 17

KOOS Like Surveys Appendix Stiffness The following question concerns the amount of joint stiffness you have experienced the last week in your knee Stiffness is a sensation of restriction or slowness in the ease with which you move your knee joint How severe is your knee stiffness after first wakening in the morning None Mild Moderate Severe Extreme Reported Outcomes Survey Pain What amount of Patient knee pain have you experienced the last week during the following activities Twisting pivoting on your knee None Mild Moderate Severe Extreme Straightening knee fully None Mild Moderate Severe Extreme Going up or down stairs None Mild Moderate Severe Extreme Standing upright None Mild Moderate Severe Extreme Rights Reserved by ViiNetwork Inc Confidential and Proprietary to ViiNetwork Inc 18